【作者】 秦永杰；

【导师】 王云贵；

【作者基本信息】 第三军医大学 ， 社会医学与卫生事业管理， 2012， 博士

【摘要】 课程是实现教育目标的主要载体。本研究以“临床医学专业学位硕士课程体系”为研究对象，通过文本研究和个案研究对我国现行临床医学专业学位硕士课程体系进行了现实审思，探讨分析了课程体系中存在的问题；再对我国临床医学硕士专业学位的性质和课程特点进行分析和讨论，以能力本位教育等理论为指导，提出构建以能力为基础的临床医学专业学位硕士课程体系的设计构想；并用德尔菲法构建了我国临床医学专业学位硕士研究生核心能力指标体系；最后在此基础上，构建出了“层次+模块”的临床医学专业学位硕士研究生课程体系。全文共分六个部分。第一部分是导论，主要介绍选题缘由、研究目的、研究意义，对国内外临床医学人才核心能力和临床医学教育课程进行了文献研究，界定了基本概念，阐述了研究内容、研究方法和研究思路，并设计了技术路线图。第二部分对我国现行临床医学专业学位硕士课程体系现状进行现实审思。通过对我国具有首批临床医学硕士专业学位授予权的22所医学院院校作为研究对象，对其临床医学专业学位硕士研究生的课程设置情况进行文本研究，并以某军医大学为代表，对我国临床医学专业学位硕士的课程体系进行个案研究。根据文本研究和个案研究结果，探讨和分析了我国临床医学专业学位硕士研究生课程体系中存在的问题。第三部分分析了我国临床医学专业学位硕士核心能力课程体系构建的理论基础。通过对我国临床医学硕士专业学位性质和课程特点的分析和讨论，以能力本位教育理论、人的全面发展学说、杜威实用主义教学观、协商课程理论和新职业主义理论作为构建以能力为基础的临床医学专业学位课程体系的理论指导，逐一对课程体系的构成要素、价值取向、构建理念、构建思路和构建工具进行了分析，提出基于核心能力的课程体系的设计构想。第四部分构建了我国临床医学专业学位硕士研究生核心能力指标体系。根据我国临床医学硕士专业学位的培养目标和临床医生的职业特点，通过小组讨论、专家访谈等方法从社会需求、学员需求、学科发展和职业发展四个角度对能力需求进行综合分析，初步形成临床医学专业学位硕士核心能力指标体系框架。再用德尔菲法对指标体系进行确定，通过选取具有代表性的专家教授，经过两轮咨询，筛选临床医学专业学位硕士核心能力指标，并用优序图法对各项指标进行判定评分，确定其权重，确定临床医学专业学位硕士核心能力指标体系，最后对指标体系进行了分析讨论。第五部分是基于核心能力的临床医学专业学位硕士课程体系的构建。以构建出的临床医学专业学位硕士核心能力指标体系为基础，以能力本位教育等理论为指导，以DACUM课程开发模式和目标模式为课程体系设计工具，借鉴现代高等教育理论、课程理论等相关理论，从课程目标、课程内容、课程实施和评价策略等方面入手，对我国临床医学专业学位硕士研究生课程体系进行构建，并对构建的课程体系进行了讨论。第六部分是全文总结。对本研究的研究、创新点、研究局限性进行了讨论分析，并对研究成果的推广和应用提出了建议。本研究在国际医学教育改革的背景下，从我国临床医学专业学位硕士课程体系这个改革热点出发，将能力本位教育理论引入临床医学专业学位教育，提出以能力为基础进行临床医学专业学位硕士课程体系的设计构想，并对临床医学专业学位硕士的核心能力、课程理念、价值取向、课程目标、课程内容、课程实施、课程评价等方面进行了深入分析和探讨，既丰富了临床医学专业学位课程构建的理论储备，又为其他院校进行临床医学专业学位课程改革提供了参考和借鉴，同时，也是我国医学教育课程体系国际化的有益尝试。更多还原

【Abstract】 In this paper, the curriculum system for postgraduates majoring in clinical medicine istaken as research object. It analyzes the curriculum system by textual and survey researches,discusses the problems of the curriculum system, makes analyses on the degree nature andcharacteristics of courses, puts forward the tentative idea about the curriculum systemconstruction, establishes the index system of core competence by Delphi method, and formsthe competence-based curriculum system at last. The paper is divided into six parts.The first part is introduction about the reason of the title-choosing, the researchpurpose, meaning, basic concepts, contents, methods and the technology roadmap throughliterature search on clinical medical talents’ core ability and clinical medicine educationcourses at home and abroad.The second part is the introspection about the status quo of Chinese curriculum systemfor masters of professional degree in clinical medicine. Taking twenty-two medical colleges,the first batch having authorization of conferring professional master degree of clinicalmedicine in China, as research subjects, text research was carried out on the professionaldegree curriculum of clinical medicine. Researches were done in the Third MilitaryMedical University used as the example. According to the results related, the problemsexisting in curriculum construction have been discussed.In the third part, the theoretical study in curriculum construction of core competenceof professional degree master majoring in clinical medicine is given. Based on the clinicalmaster degree’s nature, characteristics of the course, the theories like the Ability BasedEducational Theory, the Doctrine of Comprehensive Development, Dewey PragmatismTeaching Concept, the Negotiation Curriculum Theory and the New Career Theory, theforming elements, the value orientation, ideas and the train of thought are analyzed, and thecurriculum construction assumption has been put forward.In the fourth part, the construction of index system of core competence is finished. According to the teaching objectives and characteristics of the vocation and through groupinterview and expert interview, we analyzed the requirement of the society and cadets, thedevelopment of the discipline and the vocation, and finished initially the index system ofcore competence. Then we screened the index of core competence through the Delphimethod and two rounds of experts interview. After that, we established and analyzed theindex system through precedence diagram method.In the fifth part, the curriculum system, based on the core competencies, of clinicalprofessional degree master has been constructed. From the aspects of curriculum objectives,contents, implementation and evaluation methods, we have finished and discussed thecurriculum system on the basis of the established index system, Competency BasedEducation Theory, DACUM Curriculum Development Model, Target Model CurriculumSystem, theories of modern higher education and curriculum theory.In the sixth part, summary of the text，the innovation and the limits of this study havebeen given, and the suggestions about the application of this research have been listed.Along with the trend of the international medical education reform, this study startsfrom the point of the master curriculum reform of the professional degree of clinicalmedicine, and constructs the competency-based curriculum system. In the study, the corecompetence, ideas of courses, value orientation, objectives, contents, implementation, havebeen discussed and the theories related have been enriched, which has served as a referencefor the curriculum reform in other universities, and at the same time, as a trial ofinternationalization of curriculum system of medical education.更多还原